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What can a podiatrist do for a cyclist?

The foot is a pretty vital structure in cycling, especially if you are a competitive cycler. We depend on the foot to transfer all the load and forces to the pedal to work harder. The structure, integrity and comfort is vital to that process. Any problems are going to lessen performance if you are a competitive athlete and be a source of discomfort if you are a recreational cyclist.

podiatry cycling

Podiatrists diagnose and treat problems of the foot and often are very involved in cycling issues from the pain that can occur in the foot, to the set up of the bike, footwear and pedal and also the alignment issues of the foot for optimum performance and injury treatment and prevention. They will give advice on cycling footwear and the correct fit. Typically that footwear has to be quite tight fitting, which can result in a range of problems from pinched nerves and numb feet. Podiatry often use cycling orthotics to help these types of problems and to improve foot alignment. There was a good discussion on Podiatry Arena between podiatrists on foot othoses and cycling that is worth browsing if you want to follow this topic. In addition, they have these threads on cycling.

PodChatLive has this episode on Podiatry and cycling and this explain more about foot orthotics and what podiatrists can do to help the foot problems in cyclists.

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Is Overpronation a problem in runners?

If you read in many places, you would think that this thing of “overpronation” is evil and something that runners must do about if they have it. Overpronation is when the rearfoot rolls inwards at the ankle and the arch collapses. Foot orthotics and motion control running shoes are widely advocated to treat this. It is quite common to see this advanced as quite a problem in running magazine and running shoe websites. This has been linked to injuries such as plantar fasciitis, medial tibial stress syndrome and runners knee.

On the other hand, you have this video of Haille Gebrselassie running and very severely overpronation. Yet he was at the top of his game and never had any problems with his overpronation. This has led to lots of debates in professional circles and social media about this overpronation.

The reality is that if you read the actual scientific evidence (summarized here), yes overpronation is a problem, but a small problem, though statistically significant. It does increase the risk for a range of injuries in runners, but only a small amount.

The whole area is subject to many myths and to see clearly through it is that you need to stick to what the actual data and evidence shows. The above video of Haille Gebrselassie is an anecdote and not scientific evidence. As pointed out here, you can’t bring anecdotes to debates about data. There is really no debate, the evidence is quite clear on this.

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Heel Pain in Child Athletes

Severs disease (or more appropriately called Calcaneal apophysitis) is a common injury to the growth plate at the back of the heel bone in children that play a lot of sport.

The growth plate at the back of the heel is located where the heel contacts the ground during walking and running. The Achilles tendon also inserts into that growth plate, so the pull from the Achilles tendon and the impact of that growth plate in the ground, it can be easy to see why in sports that Severs disease can be quite common. The pain is typically at the back, bottom and side of the heel bone, especially after sport. It can be particularly painful to squeezing of the heel bone.

An episode of PodChatLive had an in-depth discussion of calcaneal apophysitis/Severs Disease and is well worth listening to:

The management of Severs disease typically involved managing lifestyle and the loads. Physical activities and sports need to be reduced, but this can be very challenging in the child when the parents are not around. ICE, as cold therapy may be help to reduce the pain after sports activity of the pain is bad enough. A shock absorbing heel insert can often be helpful to protect the heel bone from stress and cushion it. This can also lesson the pull from the Achilles tendon on the growth plate.